Faria K-M, Brandão T-B, Silva W-G, Pereira J, Neves F-S, Alves M-C, ShinLeataku W-H, Lopes M-A, Ribeiro A-C-P, Migliorati C-A, Santos-Silva A-R
Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil, Av. Limeira, 901, Areao, Piracicaba, Sao Paulo, Brazil, CEP: 13414-903,
Med Oral Patol Oral Cir Bucal. 2018 Jan 1;23(1):e38-e43. doi: 10.4317/medoral.22123.
The purpose of this study was to investigate the presence of punched-out lesions in craniofacial bones using three different radiographic protocols in a large cohort of patients.
One hundred fifty-five MM patients were evaluated using panoramic and skull (frontal and lateral) radiographs, which were performed in all patients at the time of MM diagnosis. The diagnostic potential for detecting punched-out lesions was compared among the radiographic techniques.
MM punched-out lesions were identified in 135 (87%) panoramic radiographs, 141 (91%) frontal and 144 (93%) lateral skull radiographs. Punched out-lesions were synchronously present in skull and jawbones in 129 (83.23 %) cases. The lesions were detected exclusively in skull in 18 (11.61%) cases and exclusively in jawbones in 6 (3.87%) cases. Punched out-lesion mainly affected the skull and the jawbones in a synchronous way (p<0.001) rather than separately.
All investigated radiographic techniques (panoramic, frontal and lateral skull approaches) demonstrated high detection rates for MM punched-out lesions in craniofacial bones. Panoramic radiography may aid to the radiographic protocols to identify multiple myeloma bone lesions.
本研究的目的是在一大群患者中使用三种不同的放射成像方案来调查颅面骨中筛孔状病变的存在情况。
155例多发性骨髓瘤（MM）患者在MM诊断时均接受了全景片及头颅（正位和侧位）X线片检查，比较了这些放射成像技术检测筛孔状病变的诊断潜力。
在135例（87%）全景片、141例（91%）头颅正位片和144例（93%）头颅侧位片中发现了MM筛孔状病变。129例（83.23%）患者的颅骨和颌骨同时出现筛孔状病变。18例（11.61%）患者仅颅骨出现病变，6例（3.87%）患者仅颌骨出现病变。筛孔状病变主要以同步方式累及颅骨和颌骨（p<0.001），而非单独累及。
所有研究的放射成像技术（全景片、头颅正位和侧位片）对颅面骨中MM筛孔状病变均显示出较高的检出率。全景片摄影可能有助于在放射成像方案中识别多发性骨髓瘤骨病变。
